Around the age of three, it was apparent that either S was gender variant or trans. We just had to wait to see how it would emerge," Jipala says as she and Nathan alternate addressing their five-year-old, A, and me on the back porch of Nathan's house. Jipala and Nathan, both 30-something, live separately in Kingston, but they co-parent their two children. Nine-year-old S is in another room, working up the courage to come greet me. S knows I'm there to learn about her situation.
S was born with male anatomy, but as soon as she could talk, made it known that she was a girl. When she went to camp at the age of six, S transitioned, sporting a full girls' wardrobe and switching to female pronouns. Everyone knows: her school, friends, and family. But Jipala and Nathan recognized that their story would need to enter the public sphere, too. "You make yourself available to advocate," Jipala says. "I have to answer questions in a certain way. 'I'm so happy you asked.'" While the impulse is to help educate, the necessity for explanation can be exhausting, too. S was unsure about being the subject of a magazine article, so the use of her first initial and just her parents' first names is their compromise to provide some privacy.
Arlene Lev, LCSW-R, of Choices Counseling and Consulting in Albany, specializes in issues related to sexual orientation, sexuality, and gender identity and expression. She says, "There's a broad spectrum of children who are gender nonconforming." Research points to differential fetal development of the sex organs and gender identity in the brain, but Lev questions the benefit of searching for the causes of being transgender. "We're just beginning to understand how the brain works," says Lev. "Personally, I find the research interesting, but understanding how to make use of it clinically is more complex. What we know is that people who cross gender rules have existed in every culture since the beginning of time. The fact that a small, stable portion of the human family has this experience is just who we are."
She says parents worry about even subtle differences in gender expression that break societal rules. "We want to create a culture with greater acceptance of gender expression," says Lev. "Then the world would be safer for kids who are trans or have gender dysphoria."
Lev is a family therapist, with extensive training in how family systems work and how what happens to one member affects everyone. For the parents, the decisions surrounding transgender youth can cause distress. Sometimes when parents quell the feeling of gender discontent, children act out or become depressed, and transgender people suffer from an alarmingly high suicide rate. Same-sex couples face added judgment from a society that often doubts their capacity for parenting. For Jipala and Nathan, a big challenge is the common belief that it's a phase. As proof, people say they didn't let their kids be firemen or dinosaurs. "It's not an argument you can compare to what's happening with a trans kid," Jipala says. "Trans is not self-expression; it's primarily identity." "And parents do let kids dress up as a fireman for a whole year," Nathan points out.
"Most parents want to make their children's lives as easy and healthy as possible," Jipala says. "The cultural norms are so strong and so ingrained, maybe you'll go against them for yourself, as an adult, but you wouldn't electively choose to put your child through them. Unless it's a necessity."
Jipala and Nathan want what we all want for our kids: to support S as best they can, so she's a healthy, productive adult. When S mentions that she doesn't want facial hair, Nathan lets her know, without too much detail, that there are options. They're researching hormone blockers, which S can take for two years with minimal side effects. When discontinued, puberty resumes naturally. "That's manageable for me to think about, as a parent," Jipala says. "The goal is to give the kid more time."
As a child enters adolescence, the need to mitigate puberty for a potentially trans adulthood becomes important, because once sex characteristics develop, those features remain. In a system where counselors are needed for assessment before hormone treatment or surgery can be approved, Lev is, more than diagnosing, helping people to see if the challenges of transition are worth it for them.